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Category: Volume 07 Issue 03 March 2019
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Title: A Comparative study of treatment of intertrochanteric fractures with bipolar prosthesis and proximal femoral nail in elderly

Authors: Dr Lokesh Kumar Yogi, Dr Gagandeep Mahi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.235

Abstract

Aim: Aim of the study is to analyze and compare the functional outcomes and compare the advantages, disadvantages and possible complications associated with fixation of two different surgical modalities, PFN and bipolar prosthesis in the treatment of intertrochanteric fractures in elderly patients.

Background: Elderly patients with intertrochanteric fractures should be mobilized early to reduce the morbidity and mortality. While cemented bipolar prosthesis allows early weight bearing, the prolonged surgical time increase the blood loss and mortality, whereas with PFN once the fracture becomes stable it allows early mobilization thus overcoming the problems of recumbency.

Methodology: A Prospective Comparative Study was conducted in 30 elderly patients who were admitted and operated between July 2017 to April 2018 and had fulfilled the inclusion/exclusion criteria. They were allocated into two groups 15 patients each for PFN and bipolar prosthesis. Harris hip score was used for assessment of the results of surgery. The results thus obtained were analysed and compared.

Results: The demographic and background data of the patients in the two groups were statistically similar. At 9 months follow up PFN group patients had a mean HHS of 85.5 and bipolar prosthesis group had a mean HHS of 79.9. Pain, severity and range of hip movements were better in PFN group than bipolar prosthesis group. Radio logically 2 patients in bipolar prosthesis group had stem loosening and 1 patients had screw cut out in the PFN group with subsequent pain in the final follow up.

Conclusion: PFN is a better option for the treatment of elderly intertrochanteric fractures as the operative time is short, relative surgical ease and has less mortality. PFN also gives a better functional outcome in the late follow up than bipolar prosthesis.

Keywords: Intertrochanteric fracture, Elderly patients, PFN, Biopolar prosthesis, Harris hip score.

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Corresponding Author

Dr Lokesh Kumar Yogi

Department of Orthopaedics, Government Medical College and Hospital, Aurangabad (MH)

Mob.7083208622, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.